enterohemorragisen

Enterohemorrhagic is a medical descriptor used for diseases and pathogens that cause hemorrhagic inflammation of the gastrointestinal tract, especially the colon. In German-language medical literature the corresponding term is enterohämorrhagisch. The best-known example is enterohemorrhagic Escherichia coli (EHEC), notably the serotype O157:H7, which can produce Shiga toxins.

Pathophysiology and rationale

Enterohemorrhagic pathogens release toxins that damage intestinal endothelium, leading to hemorrhagic colitis. Shiga toxins inhibit protein synthesis in vascular and other cells, contributing to inflammation, bleeding, and, in some cases, systemic complications such as hemolytic-uremic syndrome (HUS). The disease spectrum ranges from mild diarrhea to severe, bloody diarrhea with abdominal pain.

Clinical presentation

Patients typically experience abrupt onset of cramping abdominal pain, frequent watery or bloody diarrhea, and dehydration. Fever may be absent or low. In children and older adults, there is a risk of progression to HUS, characterized by hemolytic anemia, decreased platelet count, and acute kidney injury.

Diagnosis

Diagnosis combines clinical suspicion with laboratory testing. Stool testing includes culture or molecular methods to identify EHEC and to detect Shiga toxin genes (stx1, stx2). Some laboratories test for the O157:H7 serotype, though non-O157 strains can also cause disease. Additional tests may assess kidney function if HUS is suspected.

Treatment and prevention

Management is primarily supportive: adequate hydration, electrolyte management, and careful monitoring. Antibiotic therapy and antimotility agents are generally avoided in EHEC infections, as they may increase the risk of HUS. Prevention focuses on food safety and hygiene: proper cooking of ground beef, pasteurization of dairy products, thorough washing of produce, and hand hygiene to reduce transmission.